Developing World Class Health IT


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Dougal McKechnie, CEO, NZ Health IT Cluster

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Developing World Class Health IT

  1. 1. HINZ Seminar – May 2010 Dougal McKechnie Chief Executive New Zealand Health IT Cluster
  2. 2. <ul><li>Introduction </li></ul><ul><li>Health ICT industry in New Zealand </li></ul><ul><li>Draft National Health IT Plan </li></ul><ul><li>New Zealand as a global eHealth R&D laboratory </li></ul><ul><li>Questions </li></ul>This session
  3. 3. <ul><li>Vibrant alliance of vendors and supporting members including academia, healthcare providers and policy makers </li></ul><ul><li>Vendor members are multi-nationals and local companies providing information communication and technology solutions and services to the health sector </li></ul><ul><li>Established in 2002 </li></ul><ul><li>80+ organisations </li></ul><ul><li>Estimated revenue of around NZ$350 million per annum </li></ul><ul><li>Represent members interests </li></ul><ul><li>Facilitate and seek $ for collaboration, innovations and projects </li></ul><ul><li>Neutral vehicle for dialogue between decision-makers and industry </li></ul><ul><li>Formal partnerships: NZICT, NZTE, MOH/NHB </li></ul>Health IT Cluster
  4. 4. IT Health Board Supporters Strategic partners
  5. 5. Health ICT Vendor Members Lifetime Health Diary®
  6. 6. <ul><li>On average in New Zealand every day … </li></ul><ul><ul><li>160……....babies are delivered </li></ul></ul><ul><ul><li>1,500….…people are admitted to a public hospital </li></ul></ul><ul><ul><li>2,000…….visit an emergency department </li></ul></ul><ul><ul><li>2,500….…are in community-based mental health care facilities </li></ul></ul><ul><ul><li>4,000….…outpatient appointments are held </li></ul></ul><ul><ul><li>25,000…..people are in long-term residential care </li></ul></ul><ul><ul><li>40,000…..laboratory tests are undertaken </li></ul></ul><ul><ul><li>55,000.....people visit a GP </li></ul></ul><ul><ul><li>70,000…..home visits are undertaken by allied health workers </li></ul></ul><ul><ul><li>105,000…prescriptions are dispensed in the community </li></ul></ul><ul><li>These interventions are provided by a workforce of 120,000 employed across some 17,000 organisations. </li></ul>Health interventions
  7. 7. <ul><li>Ministry of Health “Long Term System Framework” project, Gareth Morgan’s book Health Cheque and the MRG Report </li></ul><ul><li>The pressures are: </li></ul><ul><ul><li>Demographics </li></ul></ul><ul><ul><li>Long-term conditions </li></ul></ul><ul><ul><li>Workforce </li></ul></ul><ul><ul><li>New technologies and devices </li></ul></ul><ul><ul><li>Affordability </li></ul></ul><ul><ul><li>Health inequalities </li></ul></ul><ul><ul><li>Public expectations </li></ul></ul><ul><li>and these are present now and will only intensify </li></ul>‘ Health system’ challenges
  8. 8. Practices with Advanced Electronic Health Information Capacity Percent reporting at least 9 of 14 clinical IT functions* * Count of 14 functions includes: electronic medical record; electronic prescribing and ordering of tests; electronic access test results, Rx alerts, clinical notes; computerized system for tracking lab tests, guidelines, alerts to provide patients with test results, preventive/follow-up care reminders; and computerized list of patients by diagnosis, medications, due for tests or preventive care. Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
  9. 9. <ul><li>We are widely regarded internationally for the progress we have made in introducing ICT to health in an innovative and agile manner, however: </li></ul><ul><ul><li>Draft National Health IT Plan 2010 : While New Zealand was the envy of the world in adopting IT into the health system, investment in next generation systems has &quot;reached a plateau&quot; and the way forward is unclear. </li></ul></ul><ul><ul><li>DHB CIO Panel, HINZ 2009 : We are falling behind the leaders and are failing our population. Having the NHI and 90% of GPs with computers is not now a compelling story. </li></ul></ul><ul><ul><li>Victoria University 2010 : A foundation of distrust and aggressive contracting from the early 1990s often brought rigidity to relationships … that still effects constructive interaction and shared learning. This diminishes the capacity to bring collective solutions to difficult issues, and stifles the spread of innovation. </li></ul></ul>Health ICT in New Zealand
  10. 10. Some looming challenges <ul><li>The investment in EMRs by the governments of the U.S., Australia and the U.K. alone will total $100 billion over the next five years. </li></ul><ul><li>Other industries are generating increased expectations: </li></ul><ul><ul><li>online banking </li></ul></ul><ul><ul><li>social networking </li></ul></ul><ul><ul><li>PHR services </li></ul></ul><ul><li>Expert patients </li></ul><ul><li>Quality and safety agenda </li></ul><ul><li>If society is to moving to a more open and transparent dialogue about our public health system – and our health information – how tolerant will we be of inefficiency and waste, and of old models of care. We will demand better. </li></ul>
  11. 11. Draft National Health IT Plan Phase 1 (2 Years) Clinical Data Repository Phase 1 (2 Years) Phase 2 (5 years) Transfer of Care Continuum of Care - Continuum of Care - Secondary /Tertiary Secondary /Tertiary Shared Care Shared Care Primary /Community Primary /Community GP2GP GP2GP E - Prescribing E - Prescribing Medicine Reconciliation Medicine Reconciliation Clinical Data Repository Patient Vitals E - events Care Plans Decision Support Patient Vitals E - events Care Plans Decision Support
  12. 12. <ul><li>Focused plan on a relatively small number of important priority areas </li></ul><ul><li>Opportunities for ‘near-term innovation’ are limited: </li></ul><ul><ul><li>Qi4GP </li></ul></ul><ul><ul><li>Care Plans and pathways </li></ul></ul><ul><ul><li>Models of Care </li></ul></ul><ul><ul><li>‘ National systems’ </li></ul></ul><ul><li>The plan needs to recognise and allow continued investment outside the identified priorities </li></ul><ul><li>How are we going to achieve the identified priorities: </li></ul><ul><ul><li>Improve the contracting and procurement processes </li></ul></ul><ul><ul><li>Streamline the governance, prioritisation and deployment mechanisms </li></ul></ul><ul><ul><li>Supporting ‘transformational (or true) innovation’ </li></ul></ul>Initial industry response
  13. 13. <ul><li>Complimentary to the plan we need to focus now on the medium to long-term view </li></ul><ul><li>We need a new approach that promotes innovation in New Zealand and subsequent uptake and it must resolve: </li></ul><ul><ul><li>Funding </li></ul></ul><ul><ul><li>‘ Sandpit’ environment </li></ul></ul><ul><ul><li>Full solution development lifecycle </li></ul></ul><ul><ul><li>Integration with devices and technologies (everyday and medical) </li></ul></ul><ul><ul><li>Clinical trials and access to provider organisations </li></ul></ul><ul><ul><li>Intellectual Property ownership </li></ul></ul><ul><ul><li>Implementation across New Zealand </li></ul></ul><ul><ul><li>Commercialisation and offshore earnings </li></ul></ul><ul><li>The Open Health Collaborative (led by Orion Health), NZTE, NIHI and the Health IT Cluster are all working to advance this vision </li></ul>New Zealand as a Global eHealth R&D Lab